Individual
MRS. KIMBERLY DEMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 E IDAHO ST, SUITE 300, BOISE, ID 83712-6267
(208) 381-7370
Mailing address
100 E IDAHO ST, SUITE 300, BOISE, ID 83712-6267
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
N-36946
ID
363LF0000X
Family Nurse Practitioner
Primary
NP-1699A
ID
Other
Enumeration date
04/18/2016
Last updated
04/18/2016
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